Infectious Disease
Case 21: A Febrile Traveller Returning from the Gambia
CASE
A 40‐year‐old woman had come back from the Gambia 2 weeks ago. She presented to A&E with a 4‐day history of general lethargy, fever and muscle ache. She stayed in a semi‐rural area and ate local cuisine. She denied any sexual contact during her trip. She had taken doxycycline as chemoprophylaxis for malaria but missed a few doses. She had been bitten by mosquitoes on numerous occasions.
On examination she was febrile, tachycardic with a heart rate of 110 beats/min and had an arterial blood pressure of 115/80 mmHg. Her respiratory rate was 18 breaths/min with an oxygen saturation of 99% on air. She had a clear chest, normal heart sounds and a soft and non‐tender abdomen.
The following results were available to you:
Hb 9.4 g/dL WCC 14 × 109/L Platelets 100 × 109/L ESR 40 mm/h U&Es Normal Albumin 29 g/L Bilirubin 50 µmol/L ALT Normal ALP Normal
QUESTION 1
Your score this session: 0 of 0
How is the diagnosis most likely to be established?